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1.
Allergol. immunopatol ; 47(2): 128-132, mar.-abr. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-180800

RESUMO

Introduction: Beta-lactams are the most frequently used antibiotics in pediatric age. Anaphylactic reactions may occur and need to be properly studied, but studies in children are scarce. Objective: Characterization of case reports of anaphylaxis in children referred to an allergy department with suspected beta-lactams hypersensitivity. Materials and methods: Retrospective analysis of all children referred to our Drug Allergy Center with suspected beta-lactams hypersensitivity between January 2011 and December 2016. Description of the drug allergy work-up performed studied according to standardized diagnostic procedures of ENDA/EAACI, including specific-IgE assay, skin prick and intradermal tests and diagnostic/alternative drug challenge tests. Results: 146 children with suspected beta-lactams hypersensitivity were studied, and in 21 (14.4%) the diagnosis was confirmed. In all of them, except for three children, an alternative beta-lactam was found. In seven children (33.3% of those with confirmed beta-lactams hypersensitivity) anaphylaxis was confirmed, and all of them described reactions with cutaneous and respiratory or gastrointestinal involvement. The culprit drug was amoxicillin in six and flucloxacillin in one. In this sample, we also performed oral challenge with cefuroxime, being negative in all cases. Almost all cases of confirmed anaphylaxis (six from seven cases) were IgE mediated, with positive skin tests despite negative serum specific-IgE. Conclusions: Allergic reactions to beta-lactams, although rare in children, require a detailed clinical history and a specialized drug allergy work-up to allow a correct diagnosis as well as to avoid the possibility of a potential life-threatening reaction and provide alternative drugs


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Alérgenos/imunologia , Anafilaxia/diagnóstico , Hipersensibilidade a Drogas/diagnóstico , Pele/patologia , beta-Lactamas/imunologia , Imunoglobulina E/sangue , Estudos Retrospectivos , Testes Cutâneos , Inquéritos e Questionários
2.
Miami; s.ed; s.n; Feb., 2019.
Não convencional em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1024118
3.
Artigo em Inglês | MEDLINE | ID: mdl-30249451

RESUMO

INTRODUCTION: Beta-lactams are the most frequently used antibiotics in pediatric age. Anaphylactic reactions may occur and need to be properly studied, but studies in children are scarce. OBJECTIVE: Characterization of case reports of anaphylaxis in children referred to an allergy department with suspected beta-lactams hypersensitivity. MATERIALS AND METHODS: Retrospective analysis of all children referred to our Drug Allergy Center with suspected beta-lactams hypersensitivity between January 2011 and December 2016. Description of the drug allergy work-up performed studied according to standardized diagnostic procedures of ENDA/EAACI, including specific-IgE assay, skin prick and intradermal tests and diagnostic/alternative drug challenge tests. RESULTS: 146 children with suspected beta-lactams hypersensitivity were studied, and in 21 (14.4%) the diagnosis was confirmed. In all of them, except for three children, an alternative beta-lactam was found. In seven children (33.3% of those with confirmed beta-lactams hypersensitivity) anaphylaxis was confirmed, and all of them described reactions with cutaneous and respiratory or gastrointestinal involvement. The culprit drug was amoxicillin in six and flucloxacillin in one. In this sample, we also performed oral challenge with cefuroxime, being negative in all cases. Almost all cases of confirmed anaphylaxis (six from seven cases) were IgE mediated, with positive skin tests despite negative serum specific-IgE. CONCLUSIONS: Allergic reactions to beta-lactams, although rare in children, require a detailed clinical history and a specialized drug allergy work-up to allow a correct diagnosis as well as to avoid the possibility of a potential life-threatening reaction and provide alternative drugs.

5.
Eur Ann Allergy Clin Immunol ; 50(5): 211-216, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30028111

RESUMO

Summary: Background and Objective. Drug-induced anaphylaxis (DIA) is the most common cause of fatal anaphylaxis. We aimed to characterize patients with DIA and their allergological workup. Methods. Systematic review of patients with history of DIA referred to our center over 7 years. Results. Included 125 patients (10% pediatric age), being 36 years the median age of first episode (from 1 to 74 years). The main culprits were nonsteroidal anti-inflammatory drugs (NSAIDs) (43%), antibiotics (42%) and anesthetic agents (6%). In 24% the reactions occurred in hospital setting and 14% perioperative. The etiology was confirmed in 75% through allergological workup. Conclusions. NSAIDs and antibiotics were responsible for most of DIA. The heterogeneity of mechanisms, the severity of the reactions and the lack of standardized in vivo and/or in vitro tests for some drugs do not allow to confirm the diagnosis in all cases. Patients with DIA should be evaluated in specialized centers to perform accurate diagnosis, to prevent recurrence and to find safe alternatives.

9.
J. investig. allergol. clin. immunol ; 27(4): 204-212, 2017. tab
Artigo em Inglês | IBECS | ID: ibc-165009

RESUMO

Regulatory B (Breg) cells are recognized as immunosuppressive cells. During the last few years, several subsets of Breg cells with different phenotypes and suppressive mechanisms have been described in the literature. We review the role of Breg cells in allergy based on an extensive literature search in PubMed. We describe the types and mechanisms of action of B cells and their role in the pathogenesis of several allergic diseases (allergic asthma, allergic rhinitis, food allergy, contact hypersensitivity, and anaphylaxis) (AU)


Los linfocitos reguladores del tipo B (B reg.) juegan un papel importante en el funcionamiento del sistema inmunitario. Durante los últimos años, se han descrito varios subgrupos de linfocitos B reg., con diferentes fenotipos y mecanismos supresores. Nuestro objetivo es recopilar la información existente sobre el papel de los linfocitos B reg. en Alergología, en base a una profunda investigación bibliográfica en PubMed. Describimos los tipos y mecanismos de acción de los linfocitos B y su función en la patogénesis de varias enfermedades alérgicas (asma alérgica, rinitis alérgica, alergia alimentaria, eccema de contacto y anafilaxia) (AU)


Assuntos
Humanos , Feminino , Gravidez , Linfócitos B Reguladores/imunologia , Linfócitos B Reguladores/metabolismo , Sistema Imunitário/metabolismo , Sistema Imunitário/fisiopatologia , Alergia e Imunologia/normas , Alérgenos/imunologia , Asma/patologia , Rinite/patologia , Hipersensibilidade Alimentar/patologia , Dermatite Atópica/patologia , Anafilaxia/patologia
11.
Eur Ann Allergy Clin Immunol ; 48(6): 212-219, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27852424

RESUMO

BACKGROUND: Beta-lactams antibiotics (BL) are the most frequent elicitors of allergic drug reactions. The aim of our study was to characterize the patients referred with suspected hypersensitivity (HS) to BL. METHODS: Over a three-year period (2011-2013), a total of 234 adult and paediatric patients (pts) with suspected HS to BL were investigated according to the European Network for Drug Allergy guidelines. RESULTS: HS to BL was confirmed in 43 pts (18%), without differences between adult and paediatric pts; anaphylaxis was reported by 20 pts. Diagnosis was ascertained by: serum-specific IgE antibodies in 5 pts (12%), skin prick tests in 5 (12%), intradermal tests in 25 (58%), 3 with delayed reading, and the remaining 8 (18%) by drug provocation tests. Penicillins / derivatives were the culprit drugs in 39 pts, mainly amoxicillin, and cephalosporins in 4. CONCLUSION: In most of these patients with suspected HS to BL, allergological work-up was negative and HS was excluded. One fourth of confirmed cases had a plausible non-IgE mediated mechanism.


Assuntos
Antibacterianos/efeitos adversos , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/epidemiologia , beta-Lactamas/efeitos adversos , Adolescente , Adulto , Idoso , Antibacterianos/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Testes Imunológicos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , beta-Lactamas/imunologia
12.
Leukemia ; 29(5): 1186-94, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25388955

RESUMO

Knowledge about clonal diversity and selection is critical to understand multiple myeloma (MM) pathogenesis, chemoresistance and progression. If targeted therapy becomes reality, identification and monitoring of intraclonal plasma cell (PC) heterogeneity would become increasingly demanded. Here we investigated the kinetics of intraclonal heterogeneity among 116 MM patients using 23-marker multidimensional flow cytometry (MFC) and principal component analysis, at diagnosis and during minimal residual disease (MRD) monitoring. Distinct phenotypic subclones were observed in 35/116 (30%) newly diagnosed MM patients. In 10/35 patients, persistent MRD was detected after 9 induction cycles, and longitudinal comparison of patient-paired diagnostic vs MRD samples unraveled phenotypic clonal tiding after therapy in half (5/10) of the patients. After demonstrating selection of distinct phenotypic subsets by therapeutic pressure, we investigated whether distinct fluorescence-activated cell-sorted PC subclones had different clonogenic and cytogenetic profiles. In half (5/10) of the patients analyzed, distinct phenotypic subclones showed different clonogenic potential when co-cultured with stromal cells, and in 6/11 cases distinct phenotypic subclones displayed unique cytogenetic profiles by interphase fluorescence in situ hybridization, including selective del(17p13). Collectively, we unravel potential therapeutic selection of preexisting diagnostic phenotypic subclones during MRD monitoring; because phenotypically distinct PCs may show different clonogenic and cytogenetic profiles, identification and follow-up of unique phenotypic-genetic myeloma PC subclones may become relevant for tailored therapy.


Assuntos
Mieloma Múltiplo/genética , Separação Celular , Técnicas de Cocultura , Progressão da Doença , Resistencia a Medicamentos Antineoplásicos , Citometria de Fluxo , Humanos , Imunofenotipagem , Hibridização in Situ Fluorescente , Mieloma Múltiplo/classificação , Fenótipo , Plasmócitos/citologia , Análise de Componente Principal , Prognóstico , Células Estromais/citologia
13.
Rev. cuba. invest. bioméd ; 32(4): 431-444, oct.-dic. 2013.
Artigo em Espanhol | LILACS-Express | ID: lil-705690

RESUMO

Antecedentes: la asociación entre los inhibidores de la bomba de protones (IBP) y el riesgo de osteoporosis y fracturas óseas es un tema que ha originado, recientemente, bastante interés en la literatura médica. Los IBP son los fármacos de primera elección en enfermedades que evolucionan con incremento de la secreción ácida y, debido al aumento progresivo de su prescripción, su potencial toxicidad se investiga periódicamente. Objetivos: en la presente revisión se analizan las bases fisiofarmacológicas y la limitada evidencia clínica de una potencial relación entre la administración continuada de IBP y la aparición de osteoporosis y fracturas óseas. Ambas patologías, relacionadas con la homeostasis del calcio, son de gran importancia en pacientes de edad avanzada por su mal pronóstico general y las consecuencias invalidantes que conllevan.


Background: the relationship between proton pump inhibitors (PPI) and the risk of osteoporosis and bone fractures is a topic of great interest in recent medical literature. PPI are first choice drugs for diseases evolving with an increase in acid secretion. Due to their growing prescription, their potential toxicity is periodically verified. Objectives: the present review analyzes the physiopharmacological bases and limited clinical evidence of a potential relationship between continued administration of PPIs and the appearance of osteoporosis and bone fractures. Both conditions are related to calcium homeostasis, and their relevance in elderly patients is high, due to their poor general prognosis and disabling effects.

14.
Arq. bras. med. vet. zootec ; 63(6): 1595-1598, dez. 2011.
Artigo em Português | LILACS-Express | ID: lil-608990

RESUMO

The prevalence of antibodies against bluetongue virus was investigated in 41 dairy goats and 40 sheep herds in the semi-arid region of Pernambuco state and the conditions for insect Culicoides maintenance, considering climate dynamics and vector competence, were evaluated. The percents of seropositive herds in agar gel immunodiffusion test for bluetongue virus group were 24 for goats and 27.5 for sheep. The estimated prevalences of seropositive animals were 3.9 percent for goats (n = 410) and 4.3 percent for sheep (n = 400). The prevalences of seropositive animals were low in the mesoregion of Sertão Pernambucano (4.8 percent for goats and 4.1 percent for sheep) and São Francisco Pernambucano (1.0 percent for goats and 4.5 percent for sheep). There were no significant differences between species and regions. Considering the social and economic importance of goats and sheep raising in the semi-arid region, it is essential to establish preventive measures to control imports of ruminants from these areas.

15.
Arq. bras. med. vet. zootec ; 58(4): 511-517, ago. 2006. tab
Artigo em Português, Inglês | LILACS | ID: lil-438718

RESUMO

Estudou-se o efeito da superalimentação no desenvolvimento do esqueleto de 14 cães da raça Dogue Alemão, utilizando dieta hipercalórica (ração super-premium) associada ao método de alimentação à vontade. Os animais foram distribuídos em dois tratamentos, sendo a ração fornecida à vontade ou restrita. O consumo de alimento foi registrado diariamente e realizaram-se, mensalmente, radiografias do cotovelo e, bimestralmente, do ombro, do quadril e do carpo, visando acompanhar alterações do esqueleto, especificamente quanto ao aparecimento da osteocondrose do ombro e da metáfise distal da ulna, da osteodistrofia hipertrófica e da displasia coxofemoral (DCF). Ao final do experimento, seis cães do grupo que recebeu alimentação à vontade apresentaram-se gordos (87,7 por cento) e um animal obeso (14,3 por cento). Do grupo de alimentação restrita, três filhotes mostraram condição corporal ideal (42,8 por cento), e quatro apresentaram-se magros (57,2 por cento). O exame radiológico revelou alterações compatíveis com o diagnóstico de DCF nos dois grupos; nos alimentados à vontade, a prevalência foi de 51,1 por cento e nos restritos, de 28,6 por cento. A osteocondrose na metáfise distal da ulna, conhecida como retenção do núcleo cartilaginoso, foi observada apenas nos cães alimentados à vontade (57,1 por cento). A superalimentação provocada pelo método de alimentação à vontade, associada com dieta de alta palatabilidade e alta densidade energética em filhotes da raça Dogue Alemão, induziu ao aparecimento de osteocondrose na metáfise distal da ulna e de displasia coxofemoral.


The effects of overfeeding on growing Great Dane puppies were examined by ad libitum feeding of a hypercaloric diet (super premium ration). Fourteen puppies from six litters were divided into two groups, with representation from each litter in each group. The dogs in the overfed group were provided ad libitum access to the diet from 8 AM to 6 PM daily, while the restricted group received the same feed but in amounts recommended by the manufacturer at 7 AM, 12:30 PM and 5 PM. Daily intake was individually recorded. To monitor skeletal changes due to osteochondrosis, hypertrophic osteodystrophy and hip dysplasia, elbow radiographs were taken monthly and shoulder, pelvis and corpus radiographs were taken bi-monthly. Weekly feed consumption and weight gain were greater in ad libitum than in restricted puppies (P<0.01). At the end of the experiment, 85.7 percent of the ad libitum group was over weight and 14.3 percent was obese, whereas 57.2 percent of restricted puppies were slim and 42.8 percent had ideal body weight. None of the dogs had hypertrophic osteodystrophy. Radiographic examination showed alterations compatible with hip dysplasia in both groups, but such observations were more frequent and more severe in the ad libitum group. Osteochondrosis of metaphisis distal ulna, known by the retention of cartiloginous nucleus, was observed only in the ad libitum group, at a rate of 57.1 percent. The thickness of the cortical and diameter of the ulna were greater (P<0.01) in ad libitum dogs than in those fed a restricted amount of the same diet. In summary, overfeeding caused by ad libitum access to a highly palatable and high energy food caused osteochondrosis and hip dysplasia in Great Dane puppies.


Assuntos
Animais , Cães , Displasia Pélvica Canina/diagnóstico , Displasia Pélvica Canina/epidemiologia , Osteocondrite/diagnóstico , Osteocondrite/epidemiologia , Ração Animal/análise , Ração Animal/efeitos adversos , Ulna/patologia
16.
Toxicon ; 43(7): 801-10, 2004 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-15284014

RESUMO

In Brazil, the Crotalus durissus terrificus subspecie is the most studied, particularly concerning its crotoxin. Crotoxin is the major toxic component of the South American rattlesnake Crotalus durissus venom. It is composed of two different subunits, CA called crotapotin and CB weakly toxic phospholipase A2 with high enzymatic activity. In this paper, we decided to make a study of the main toxic characteristics of crotoxin (CTX) and CB fraction from the other subspecies, Crotalus durissus cascavella and of Crotalus durissus collilineatus, in comparison with those of C. d. terrificus. Ours results have shown that the venoms presented similar chromatographic profiles and the purified fractions were free of contaminants. Regarding the toxic activities, the DL50 of the crotoxins showed no significant differences between the subspecies. The smaller toxicity of CB indicated that the toxicity of the crotoxin complex depends on the interaction between CA and CB. CTX and fraction CB of the three species of Crotalus showed negligible proteolytic activity. C. d. terrificus CTX presented higher PLA2 activity when compared with the others two subspecies. The oedema induced by CB developed later than the CTX and reached its peak 3 h after the injection. The myotoxic activity was determined by assaying serum CK levels. Mice injected with CTX of C. d. terrificus presented greater myotoxic activity compared to the others. The myotoxic activity of CB from the three subspecies was lower than the activity of the crotoxin, reinforcing the idea that the fraction CA increases the toxicity of CB.


Assuntos
Crotalus , Crotoxina/toxicidade , Fosfolipases A/toxicidade , Análise de Variância , Animais , Brasil , Caseínas/metabolismo , Cromatografia por Troca Iônica , Creatina Quinase/sangue , Crotoxina/metabolismo , Edema/induzido quimicamente , Eletroforese em Gel de Poliacrilamida , Dose Letal Mediana , Camundongos , Camundongos Endogâmicos BALB C , Fosfolipases A/metabolismo , Fosfolipases A2 , Fatores de Tempo , Testes de Toxicidade Aguda
18.
Toxicon ; 39(10): 1567-73, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11478964

RESUMO

The release of pro-inflammatory cytokines (IL-1beta, IL-6 and TNF-alpha) from murine peritoneal adherent cells (MPAC) was studied after exposure to jararhagin, a metalloproteinase/disintegrin isolated from Bothrops jararaca venom. MPACs were treated with LPS (lipopolysaccharide), jararhagin, or EDTA-inactivated jararhagin for up to 24h. Following incubation, the culture supernatant was assayed by ELISA for the presence of cytokines, while the cells were analysed for viability and cytokine mRNA expression. The cells exposed to native jararhagin released TNF-alpha and IL-1beta after 4 and 24h respectively. When MPACs were exposed to Jararhagin treated with EDTA, TNF-alpha and IL-1beta production was sustained throughout the culture period and IL-6 production was observed. TNF-alpha, IL-6 and IL-1beta mRNA were detected 4h after stimulation with either native or EDTA-treated jararhagin. Addition of jararhagin to LPS stimulated cells resulted in a dramatic decrease in the release of IL-6 and TNF-alpha. RT-PCR showed that this inhibition does not occur at the transcriptional level and further experiments showed that jararhagin degraded soluble cytokines by proteolytic activity. This study suggests that jararhagin induces TNF-alpha, IL-1beta and IL-6 expression, which may be rapidly degraded by its proteolytic activity.


Assuntos
Bothrops , Venenos de Crotalídeos/antagonistas & inibidores , Venenos de Crotalídeos/farmacologia , Citocinas/farmacologia , Ácido Edético/farmacologia , Interleucina-1/metabolismo , Interleucina-6/metabolismo , Lipopolissacarídeos/farmacologia , Macrófagos Peritoneais/imunologia , Metaloendopeptidases/antagonistas & inibidores , Metaloendopeptidases/farmacologia , Cavidade Peritoneal/citologia , RNA Mensageiro/biossíntese , Fator de Necrose Tumoral alfa/metabolismo , Animais , Sobrevivência Celular/efeitos dos fármacos , Venenos de Crotalídeos/química , Venenos de Crotalídeos/enzimologia , Venenos de Crotalídeos/toxicidade , Combinação de Medicamentos , Ácido Edético/antagonistas & inibidores , Ensaio de Imunoadsorção Enzimática , Inflamação , Quelantes de Ferro , Lipopolissacarídeos/antagonistas & inibidores , Macrófagos Peritoneais/efeitos dos fármacos , Metaloendopeptidases/química , Metaloendopeptidases/isolamento & purificação , Metaloendopeptidases/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Inibidores da Agregação de Plaquetas , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Tempo
19.
J Parasitol ; 87(1): 114-7, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11227874

RESUMO

The distribution of epimastigote forms of Trypanosoma cruzi in the microcirculatory network and the vessel alterations were observed using an intravital microscopy technique. Immediately after intravenous inoculation of 2 x 10(6) epimastigote suspension into normal mice, parasites were seen as circulating clumps, and their retention at some sites of the endothelium of venules and capillaries was observed. Injection of 2 x 10(7) and 2 x 10(8) parasite suspensions induced, respectively, intermittent or total stasis of venules and capillaries, probably via obstruction by clumping. The mobility of epimastigotes in the clumps indicates that parasites were alive in the lumen of vessels. The retention of clumps in the capillaries, although intense, could only be observed when labeled parasites were inoculated. These results suggest that the rapid clearance of epimastigote forms of T. cruzi from the blood circulation of mice may be due to the retention of parasites to the endothelium of venules and capillaries that, in turn, may facilitate phagocytosis. This may be a mechanism by which mice are able to eliminate epimastigote forms from the circulation. These findings are consistent with our previous observations showing that epimastigotes are not lysed by complement activation but are phagocytosed and destroyed by a distinct population of blood cells.


Assuntos
Microcirculação/parasitologia , Músculo Esquelético/irrigação sanguínea , Trypanosoma cruzi/fisiologia , Animais , Doença de Chagas/parasitologia , Doença de Chagas/patologia , Processamento de Imagem Assistida por Computador/métodos , Masculino , Camundongos , Microcirculação/patologia , Microscopia de Fluorescência/métodos , Músculo Esquelético/patologia , Trypanosoma cruzi/crescimento & desenvolvimento
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